Patient education: Uterine cancer (The Basics)

What is uterine cancer? — 

Uterine cancer happens when normal cells in the uterus change into abnormal cells and grow out of control. The uterus is the part of the body that holds a baby if you are pregnant. The uterus has a thin inner lining layer and a thick outer layer (figure 1).

There are different types of uterine cancer, but most uterine cancer starts in cells in the thin inner lining. Uterine cancer can occur at any age but is much more common in people who have gone through menopause. (Menopause is the time in life when you stop having menstrual periods.)

What are the symptoms of uterine cancer? — 

The most common symptom of uterine cancer is abnormal vaginal bleeding. Abnormal vaginal bleeding includes:

●Bleeding in between menstrual cycles (when you are not having your period)

●Menstrual bleeding that is heavier than usual

●Any vaginal bleeding if you have been through menopause

These symptoms can also be caused by conditions that are not cancer. But if you have these symptoms, tell your doctor or nurse.

Is there a test for uterine cancer? — 

Yes. If you have abnormal vaginal bleeding, your doctor or nurse might order a test called a biopsy to check for uterine cancer. During a biopsy, a doctor takes a small sample of tissue from the uterine lining. Another doctor looks at the sample under a microscope to see if cancer is present.

If you have gone through menopause, an imaging test called an ultrasound might be done first to check for uterine cancer. This test measures how thick the uterine lining is. If the lining appears abnormal, a biopsy will be done.

What is cancer staging? — 

Cancer staging is a way in which doctors find out how far the cancer has spread.

The right treatment for you depends a lot on the stage of your cancer and how fast it is growing. Your treatment also depends on your age and other medical problems.

How is uterine cancer treated? — 

Most people with uterine cancer have surgery to remove the uterus, the ovaries, and the tubes connecting the ovaries to the uterus (fallopian tubes). This surgery is called a "hysterectomy" (figure 2 and figure 3). During surgery, the doctor will also check the area and organs around the uterus to see if the cancer has spread. They might remove other organs that look abnormal.

Some people will not need further treatment after surgery if surgery removes the cancer. But other people might need further treatment with 1 or both of the following:

●Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.

●Radiation therapy – Radiation kills cancer cells. Radiation can be given from a machine that is outside of the body. Or a doctor can put a source of radiation directly into the vagina.

Some people can first be treated with hormone medicines called "progestins" instead of surgery. But this is done only in special situations.

What happens after treatment? — 

After treatment, you will be checked every so often to see if the cancer comes back. Your doctor or nurse will ask you about symptoms and do an exam. Follow-up tests can include blood tests and imaging tests such as X-rays or CT scans. Imaging tests create pictures of the inside of the body.

You should also watch for symptoms of abnormal vaginal bleeding, pain in your belly, or a cough that won't go away. Let your doctor or nurse know if you have these symptoms. They could mean that your cancer has come back.

What happens if the cancer comes back or spreads? — 

If the cancer comes back or spreads, you might have more surgery, radiation therapy, or chemotherapy.

What if I want to get pregnant in the future? — 

If you have not yet gone through menopause and want to have a baby in the future, talk with your doctor before starting treatment. You will not be able to get pregnant after a hysterectomy or radiation. If you need to have one of these treatments, your doctor or nurse can talk to you about other options for growing your family in the future.

What else should I do? — 

Follow all of your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.

Getting treated for uterine cancer involves making many choices, such as what treatment to have.

Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:

●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?

●What are the downsides to this treatment?

●Are there other options besides this treatment?

●What happens if I do not have this treatment?

More on this topic

Patient education: Menopause (The Basics)
Patient education: Heavy periods (The Basics)
Patient education: What are clinical trials? (The Basics)
Patient education: Preserving fertility after cancer treatment in women (The Basics)

Patient education: Abnormal uterine bleeding (Beyond the Basics)
Patient education: Endometrial cancer diagnosis, staging, and surgical treatment (Beyond the Basics)
Patient education: Endometrial cancer treatment after surgery (Beyond the Basics)
Patient education: Dilation and curettage (D&C) (Beyond the Basics)
Patient education: Abdominal hysterectomy (Beyond the Basics)
Patient education: Vaginal hysterectomy (Beyond the Basics)
Patient education: Vaginal dryness (Beyond the Basics)
Patient education: Sexual problems in females (Beyond the Basics)